골수이식 후 만성 이식편대숙주질환으로 발생한 폐쇄성 세기관지염에 의한 이차성 재발성 기흉 1례

Recurrent Secondary Pneumothorax Caused by Bronchiolitis Obliterans Due to Chronic Graft Versus Host Disease in a Patient with Chronic Myelogenous Leukemia after Allogenic Bone Marrow Transplantation

  • 안철민 (연세대학교 의과대학 내과학교실) ;
  • 황상연 (연세대학교 의과대학 내과학교실) ;
  • 변민광 (연세대학교 의과대학 내과학교실) ;
  • 이진형 (연세대학교 의과대학 내과학교실) ;
  • 정우영 (연세대학교 의과대학 내과학교실) ;
  • 문진욱 (연세대학교 의과대학 내과학교실) ;
  • 박무석 (연세대학교 의과대학 내과학교실) ;
  • 민유홍 (연세대학교 의과대학 내과학교실) ;
  • 김세규 (연세대학교 의과대학 내과학교실) ;
  • 장준 (연세대학교 의과대학 내과학교실) ;
  • 김성규 (연세대학교 의과대학 내과학교실) ;
  • 김혜령 (연세대학교 의과대학 병리학교실) ;
  • 김호근 (연세대학교 의과대학 병리학교실) ;
  • 김영삼 (연세대학교 의과대학 내과학교실)
  • Ahn, Chul Min (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Hwang, Sang Yun (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Byun, Min Kwang (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Jin Hyoung (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Chung, Wou Young (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Moon, Jin Wook (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Park, Moo Suk (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Min, Yoo Hong (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Se Kyu (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Chang, Joon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Sung Kyu (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Haeryoung (Department of Pathology, Yonsei University College of Medicine) ;
  • Kim, Hoguen (Department of Pathology, Yonsei University College of Medicine) ;
  • Kim, Young Sam (Department of Internal Medicine, Yonsei University College of Medicine)
  • 투고 : 2004.04.08
  • 심사 : 2004.06.28
  • 발행 : 2004.08.30

초록

저자들은 30세 남자 환자에서 골수이식 후 발생한 만성 이식편대숙주질환에 의한 폐쇄성 세기관지염으로 인하여 발병한 이차성 재발성 기흉의 임상적 진단 및 스테로이드와 면역 억제제 치료 후 호전된 증례를 경험하였기에 이에 문헌 고찰과 함께 보고하는 바이다.

Bronchiolitis obliterans (BO) is a nonspecific inflammatory injury affecting primarily the small airways. Its inflammatory process is characterized by fibrotic obliteration of the lumen of bronchioles. BO can be idiopathic or associated with connective tissue disease, inhaled toxins, infections, drugs, and chronic graft-versus-host-disease (GVHD). Pulmonary complications occur in 40~60% of patients who undergo allogeneic bone marrow transplantation (BMT), causing 10~40% of transplant-related deaths. BO is a characteristic pulmonary complication which occurs usually within a few years after BMT. Documented complications of BO include air-leak syndromes such as pneumomediastinum, subcutaneous emphysema and pneumothorax. We report a case of a 30-year-old male patient with BO due to chronic GVHD after allogenic BMT who presented with recurrent bilateral pneumothoraces.

키워드

참고문헌

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